Gastroenterology/ Hepatology

Question 1

Name some causes of unconjugated jaundice?

Answer 1

Physiological jaundice
Breast milk jaundice
Haemolytic disease (rhesus incompatibility or ABO incompatibility)
G6PD deficiency
Gilbert Syndrome

Question 2

Name some causes of conjugated jaundice?

Answer 2

Neonatal hepatitis
Biliary atresia
Aligille Syndrome
Alpha-1-antitrypsin deficiency

Question 3

HBsAg positive + HBeAg positive =

Answer 3

High risk (requires Hep B vaccination and IVIg)

Question 4

HBsAg positive + HBeAg negative

Answer 4

Low risk (requires Hep B vaccination only)

Question 5

HBsAg positive + e antibody positive =

Answer 5

Low risk (requires Hep B vaccination only)

Question 6

HBsAg positive + no ‘e’ antibody/ antigen =

Answer 6

Intermediate risk (requires Hep B vaccination and IVIg)

Question 7

Explain the clinical findings of conjugated bilirubinaemia?

Answer 7

Dark urine
Pale stools
Pruritis

Question 8

A caucasian child with Coomb’s negative haemolytic anaemia and splenomegaly, consider?

Answer 8

Hereditary Spherocytosis

Question 9

What are the blood results in Wilson’s disease?

Answer 9

Reduced total serum copper levels
Reduced caeruloplasmin levels
Increased urinary copper excretion

Question 10

What is the treatment of Wilson’s disease?

Answer 10

Penicillamine
Pyridoxine

Question 11

Symptoms of zinc deficiency?

Answer 11

Periorofacial dermatitis
Diarrhoea
Growth failure
Immunodeficiency

Question 12

Symptoms of copper deficiency?

Answer 12

Anaemia
Neutropenia
Osteoporosis
Soft tissue calcification

Question 13

Symptoms of selenium deficiency?

Answer 13

Cardiomyopathy
Skeletal aches and pains
Pseudoalbinism

Question 14

Symptoms of vitamin A deficiency?

Answer 14

Night blindness
Follicular Hyperplasia
Poor growth
Impaired resistance to infection

Question 15

Symptoms of vitamin E deficiency?

Answer 15

Peripheral neuropathy
Retinitis pigmentosa
Ataxia

Question 16

What are the fat soluble vitamins?

Answer 16

A, D, E, K

Question 17

Symptoms of folate deficiency?

Answer 17

Microcytic anaemia
Chronic diarrhoea
Poor growth
Thrombocytopenia
Irritability

Question 18

Which foods is folate found in?

Answer 18

Green vegetables
Yeast
Milk

Question 19

Which group of individuals are most at risk of vitamin B12 deficiency?

Answer 19

Vegans

Question 20

Symptoms of Vitamin B12 deficiency?

Answer 20

Anaemia
Glossitis
Peripheral Neuropathy

Question 21

Which agents are used in the induction and maintenance of remission in patients with Crohn’s disease?

Answer 21

Polymeric Diet - induction of remission
Thiopurines (e.g. azothioprine) - maintenance of remission in patients without perianal disease (methotrexate can be used as an alternative)
Infliximab - maintenance of remission in patients with perianal disease

Question 22

What is the management plan for a mother with HIV and a viral load of <50 copies at 36 weeks?

Answer 22

Low risk delivery
Vaginal delivery
Zidovudine therapy for 4 weeks (mono therapy)

Question 23

What is the management plan for a mother with HIV and a detectable viral load? (>400 copies)

Answer 23

Planned C-section
Triple therapy for 4 weeks

Question 24

What is the feeding advice for mothers with HIV?

Answer 24

Formula feeding (regardless of viral load or HIV prophylaxis treatment)

Question 25

List the possible causes of Chorioform movements?

Answer 25

Sydenhams Chorea - up to 6 months after rheumatic fever
Huntington’s Disease
Kernicterus, Wilson’s disease, Thyrotoxicosis
Benign Familial
SLE
Drugs e.g. metoclopromide/ dopamine